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Dermatology => Skin => Erysipelas
Erysipelas
Erysipelas, contagious and infectious skin disease, also affecting the subcutaneous tissue, characterized by inflammation of the diseased areas, with accompanying redness and swelling. Erysipelas is sometimes epidemic and is often caused by infection of wounds.
Erysipelas is caused by a bacterium, the Group A streptococcus, and first appears as a red patch raised above the normal surface of the skin. The most common starting point of the infection is the face. The redness spreads, with older areas fading as the new areas extend. On the face, the redness often assumes a characteristic butterfly shape, covering the cheeks and nose. An arm or leg is also commonly affected, often with obstruction of lymphatic channels. This occurs most frequently in older adults, children, and infants. In newborn infants, erysipelas may develop after infection of the umbilical stump. It also tends to occur in areas where lymphatics have been injured, as after an operation. Untreated erysipelas can extend into deeper tissues, with bacterial invasion of the blood stream, which can be fatal.
An 11th-century erysipelas epidemic was recorded in France, where it was called Saint Anthony's Fire. Before antibiotics became available, it was often found in undernourished people and particularly in alcoholics. Women were affected more often than men, and the condition was frequently found in association with puerperal, or childbed, fever, which was also caused by Group A streptococci.
Early cases of erysipelas can be treated with oral penicillin; more extensive involvement may require intravenous treatment. All Group A streptococci are susceptible to penicillin.
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